| NPI | 1487179388 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MD AC003878) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: WV 81133) |
| Enumeration Date | 2017-08-11 |
| Last Update Date | 2022-03-18 |